Evaluation of biomarkers following autologous osteochondral transplantation in the equine stifle joint — An experimental study

The purpose of this study was to evaluate changes in biomarker and synovial parameters following autologous osteochondral transplantation (AOT) in the equine stifle joint, to test the hypothesis whether synovial parameters would show significant differences at selected time points following the surgery (at days 3, 14, 60 and 180) compared to baseline level (at day 0). Surgical intervention was performed in both stifles of nine horses (n = 18). The joints were randomly assigned to operated and sham-operated groups. Grafts 8.5 mm in diameter were harvested from the femoropatellar (FP) joint under arthroscopic control and the medial femorotibial (MFT) joints had AOT using mosaicplasty (MP) instrumentation, while the sham FP and sham MFT joints underwent arthroscopy and miniarthrotomy without transplantation, respectively. Synovial fluid (SF) parameters were evaluated at days 4, 14, 60 and 180. Data were analysed by two-way repeated- measures analysis of variance (ANOVA), and P < 0.05 was considered significant. During the first 10–14 days after surgery, lameness of degree 2–3/5 [American Association of Equine Practitioners (AAEP) scores] was present, which disappeared after 60 days. Joints with transplantation showed significant increases in synovial white blood cell count (WBC), total protein (TP), substance P, C1,2C and CS846 epitope concentration at day 3 compared to baseline and shamoperated joints (P < 0.05). These parameters returned to the baseline values by two months after surgery and remained within normal levels at 6 months postoperatively

Új eljárás körülírt ízfelszín defektusok, valamint proliferatív synovitis gyógykezelésére mozaikplasztika valamint radiosynoviectomia segítségével lovon = Novel technique to treat circumscribed joint surface lesions and proliferative synovitis with Mosaicplasty and radiosynoviectomy in the horse.

1. Klinikai beteganyagon végzett munka 11 lovon (1-12 év), négy különböző lokalizációval sikerült SBCs eseteket összegyűjteni (femur mediális, ill. lateralis condylusán valamint a csüdízületben). A mozaikplasztikához a graftokat a femur medialis trochleájának abaxialis felszínéről vettük. A graftok implantációja miniarthrotómiából vagy artroszkópos kontroll alatt történt. Eredmények: Minden ló mozgása javult a műtétet követően; 8 ló korábbi, vagy magasabb szintű teljesítményre volt képes. Egy ló esetében négy év után tapasztaltunk recidivát. Egy esetben több együttes probléma előfordulása miatt (med meniscus sérülés) az állat tenyészértékét sikerült csak megmenteni. 2. Ló csüdízületbe végzett kísérletes beültetések 10 lovon (3-4 éves) ültettünk be 6.5 mm és 8,5 mm átmérőjű 20 mm hosszú autograftokat az elülső végtag csüdízületébe. A lovak két év elteltével kerültek végleges elaltatásra. Eredmények: a beültetett graftok tökéletesen inkorporálódtak környezetükbe, a donor areák esetében is kongruens felszínt tapasztaltunk a vizsgálatok alkalmával. Az áltültetett graftok között létrehozott porcfosztott területek két év után is csak gyengén voltak rostos porccal fedve. Ez alapján kijelenthetjük, hogy lovon is igen fontos a teherviselő ízületi felszín teljes kitöltésére törekedni. A technikai hibából kissé mélyre süllyedt graftok esetében a porckúszás különböző jelenségeit tudtuk megfigyelni. | 1. Study on clinical case log In 11 horses (1-12 years) SBCs were identified in 4 locations: medial and lateral femoral condyle, distal epiphysis of the metacarpus , or metatarsus. Osteochondral autograft transplantation (mosaic arthroplasty) was performed, taking grafts from the abaxial border of the medial femoral trochlea of the unaffected limb. Graft implantation was achieved through a small arthrotomy or by arthroscopy depending on SBC location. Results: All horses improved postoperatively; 8 horses returned to a previous or higher activity level. One horse had recurrence after 4 years of work and soundness. One stallion was used for breeding and light riding because of medial meniscal injuries on the same limb. 2. Implantations into the fetlock joint ? experimental study 10 healthy horses (3-4 years) were involved into this study. Graft, 6.5 mm and 8.5 mm in diameter and 20 mm in length were implanted into the weight bearing surface of the dist. epiphysis of the metacarpus. Horses were humanely destroyed 2 years following the first implantations. Results: Transplanted grafts were fully incorporated into the host bed; the donor areas looked congruent and smooth, without fibrillation. 2-4 mm long cartilage missing fields in-between two transplanted grafts were covered with low quality fibrillating fibrocartilage. Conclusion: even little missing hyaline cartilage on weight bearing surface has to be resurfaced even in equine species

Prognosztikai tényezők könnyűlánc-amyloidosisban

Introduction: Light chain amyloidosis is characterized by extracellular deposition of a fibrillar material derived from immunglobulin light chain fragments. Aim: The aim of the authors was to assess survival depending on cardiac involvement, therapy, and presence of myeloma. Method: The authors studied a retrospective cohort of 29 patients with light chain amyloidosis (13 kappa, 16 lambda) treated in their institution between 2005 and 2014. Results: Twenty-one patients had primary amyloidosis, while 8 had coexisting multiple myeloma. One, two and three or more organs were involved in 4, 8, and 17 patients, respectively. Cardiac involvement (22 cases) inversely correlated with survival. Fifteen (52%) patients received chemotherapy only, while 14 (48%) underwent autologous stem cell transplantation with a median survival of 87 and 11.4 months, respectively. Two patients had heart transplantation and survived 70 and 30 months. Median overall survival was 75.8 months. Conclusions: Cardiac transplantation followed by autologous stem cell transplantation is feasible in selected patients with light chain amyloidosis and heart failure

Prognosztikai tényezők könnyűlánc-amyloidosisban

Absztrakt Bevezetés: A könnyűlánc-amyloidosis immunglobulinok könnyűláncaiból származó fibrilláris anyag extracelluláris lerakódása következtében kialakuló kórkép. Célkitűzés: A szerzők célja a szívérintettség, a kezelés és a myeloma fennállásának függvényében a túlélési idők meghatározása. Módszer: Retrospektív kohorszvizsgálatban 29, 2005–2014 között intézményünkben kezelt könnyűlánc-amyloidosisos beteg dokumentációját használtuk fel. Eredmények: Primer könnyűlánc-amyloidosist 21 esetben diagnosztizáltuk. A betegek 27,6%-ában a könnyűlánc-amyloidosishoz myeloma is társult. Az amyloidogen könnyűlánc 13 betegben kappa, 16 esetben lambda típusú volt. A folyamat 17 beteg esetében ≥3, 8 esetében 2, 4 esetében 1 szervre terjedt ki. A tünetek alapján a szív 22 esetben volt érintett. A szívérintettség fordítottan korrelált a túléléssel. Tizenöt beteg (52%) csak kemoterápiában, míg 14 (48%) autológ őssejt-transzplantációban részesült. A medián túlélés 87, illetve 11,4 hónap volt. Két betegnél történt szívtranszplantáció. Ők a beavatkozást 70, illetve 30 hónappal élték túl. A medián teljes túlélés 75,8 hónapnak adódott. Következtetések: Szívtranszplantációt követő autológ őssejtátültetés a betegség progresszióját feltartóztathatja. Orv. Hetil., 2015, 156(39), 1577–1584

Delayed spontaneous remission of acquired factor V inhibitor refractory to immunosuppressive therapy with pregnancy-associated improvement

Introduction: Acquired factor V inhibitor (AFVI) is a rare autoimmune bleeding disorder. The treatment of AFVI is challenging, and patients often require both bleeding control and inhibitor eradication.Methods: We conducted a retrospective analysis of the medical records of a 35-year-old Caucasian woman who presented with severe AFVI-induced bleeding and subsequent immunosuppressive therapy.Results: To provide haemostasis, rFVIIa was given with good efficacy. The patient was treated with various combinations of immunosuppressive regimens over the course of 2.5 years, including plasmapheresis plus immunoglobulins, dexamethasone + rituximab, cyclophosphamide + dexamethasone + rituximab + cyclosporine, cyclosporin + sirolimus + cyclophosphamide + dexamethasone, bortezomib + sirolimus + methylprednisolone, and sirolimus + mycophenolate mofetil. Although these treatment modalities resulted in intermittent partial reversals of AFVI over 2.5 years, eventually the inhibitor became therapy-resistant. However, following the discontinuation of all immunosuppressive therapy, the patient experienced a partial spontaneous remission, which was followed by a pregnancy. During the pregnancy, the FV activity increased to 54% and the coagulation parameters returned to normal levels. The patient underwent Caesarean section without any bleeding complications and delivered a healthy child.Discussion: The use of an activated bypassing agent for bleeding control is effective in patients with severe AFVI. The presented case is unique because the treatment regimens included multiple combinations of immunosuppressive agents. This demonstrates that AFVI patients may undergo spontaneous remission even after multiple courses of ineffective immunosuppressive protocols. Additionally, pregnancy-associated improvement of AFVI is an important finding that warrants further investigation

Transposon-Based Reporter Marking Provides Functional Evidence for Intercellular Bridges in the Male Germline of Rabbits

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Effect of single-nucleotide polymorphisms on specific reproduction parameters in Hungarian Large White sows

The aim of this study was to reveal the effect of single-nucleotide polymorphisms (SNPs) on the total number of piglets born (TNB), the litter weight born alive (LWA), the number of piglets born dead (NBD), the average litter weight on the 21st day (M21D) and the interval between litters (IBL). Genotypes were determined on a high-density Illumina Porcine SNP 60K BeadChip. Data screening and data identification were performed by a multi-locus mixed-model. Statistical analyses were carried out to find associations between individual genotypes of 290 Hungarian Large White sows and the investigated reproduction parameters. According to the analysis outcome, three SNPs were identified to be associated with TNB. These loci are located on chromosomes 1, 6 and 13 (−log10P = 6.0, 7.86 and 6.22, the frequencies of their minor alleles, MAF, were 0.298, 0.299 and 0.364, respectively). Two loci showed considerable association (−log10P = 10.35 and 10.46) with LWA on chromosomes 5 and X, the MAF were 0.425 and 0.446, respectively. Seven loci were found to be associated with NBD. These loci are located on chromosomes 5, 6, 13, 14, 15, 16 and 18 (−log10P = 10.95, 5.43, 8.29, 6.72, 6.81, 5.90, and 5.15, respectively). One locus showed association (−log10P = 5.62) with M21D on chromosome 1 (the MAF was 0.461). Another locus was found to be associated with IBL on chromosome 8 (−log10P = 7.56; the MAF was 0.438). The above-mentioned loci provide a straightforward possibility to assist selection by molecular tools and, consequently, to improve the competitiveness of the Hungarian Large White (HLW) breed

Case Report: Effective management of adalimumab-induced acquired hemophilia A with the CyDRI protocol

IntroductionAcquired Hemophilia A (AHA) is a rare autoimmune disorder characterized by the emergence of inhibitors that specifically target coagulation Factor VIII, frequently resulting in severe bleeding episodes.MethodsWe conducted a retrospective analysis of the medical records of a 68-year-old male patient who presented with adalimumab-induced AHA.ResultsThe patient received adalimumab, a tumor necrosis factor inhibitor antibody, as part of his treatment for rheumatoid arthritis. The patient’s clinical journey, characterized by intense bleeding and coagulopathy, was effectively managed with the application of recombinant Factor VIIa (rFVIIa) and the CyDRi protocol.DiscussionThe case emphasizes the importance of prompt coagulation assessment in patients with bleeding symptoms receiving disease-modifying therapy for rheumatoid arthritis that includes adalimumab therapy, considering the rare yet life-threatening nature of AHA. Additionally, this report provides an extensive review of the existing literature on drug-induced AHA, with a special emphasis on cases linked to immunomodulatory medications. Through this two-pronged approach, our report aims to enhance understanding and awareness of this severe complication among healthcare providers, promoting timely diagnosis and intervention

Inflammation and oxidative stress caused by nitric oxide synthase uncoupling might lead to left ventricular diastolic and systolic dysfunction in patients with hypertension

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